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022 Preliminary results from a consultant-led acute neurology service based in the emergency department
Conclusions Acute Neurology input in the ED had major impacts on working diagnoses, hospital admis- sions, urgent outpatient referrals, and emergency investigations.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Alim-Marvasti, A., See, I., Kandasamy, R., Hutchinson, J., Lane, C., Baruah, T., Balaratnam, M., Chandratheva, A., Simister, R., Haider, S. Tags: Poster presentations Source Type: research

Atypical clinical presentations are common in TIA and minor stroke patients with DWI-MRI confirmed ischaemia
Conclusions Over one-third with DWI-confirmed TIA/minor stroke present atypically. The value of atypical symptoms in excluding ischaemia, particularly in patients with vascular risk factors, appears limited.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Gallogly, P., Best, J., Werring, D., Hassan, J., Lee, C., Cousins, J., Jäger, R., Chandratheva, A. Tags: Parallel Session 3: Acute/Vascular/Trauma Wed 18 May, 1445 - 1600 2 Source Type: research

136 Coincidential hydrocephalus in twins with CMT1X
Discussion Despite the finding of hydrocephalus in both affected twins, further family evaluation confirmed the hydrocephalous not to segregate with the GJB1 mutation. This highlights the importance of detailed phenotype segregation studies before diagnosing an atypical phenotype with genetic diseases. Alterna- tive genetic causes for the hydrocephalus are being sought. 1) Vivekanandam V, Hoskote C, Rossor AM, Reilly MM. CNS phenotype in X linked Charcot- Marie-Tooth disease. J Neurol Neurosurg Psychiatry 2018 Dec 5;90(9). carolynnedoherty@doctors.org.uk|NIHR Bursary 93
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Doherty, C., Pipis, M., Hosktote, C., Rossor, A., Reilly, M. Tags: Live Poster, 13 May Poster Session 2 Source Type: research

Long-term follow-up of acute functional stroke mimic in comparison to mild acute ischaemic stroke
Introduction Each year many patients are admitted to the emergency department with a suspicion of acute ischaemic stroke (AIS). There are several conditions that can present with acute stroke-like symptoms, of which the most common are seizures, migraine and functional disorder. The latter are called functional stroke mimics (FSM). While the outcome of patients with AIS has extensively been studied, little is known about the outcome of FSM. Short-term follow-up studies in acute FSM have shown that about 80% of patients with FSM still reported symptoms after 2 months,1 but long-term follow-up studies are lacking. We therefo...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Lambert, F., Venema, J. S., Tijssen, M. A., Rosmalen, J., Uyttenboogaart, M., Luijckx, G.-J. Tags: PostScript Source Type: research

011 Progressive myoclonic epilepsy due to rare mitochondrial ND6 mutation, m.14487T>C
We report the case of a 43-year old man with adult-onset drug-resistant epilepsy, cortical myoclonus and bilateral optic neuropathies. Serial MRI scans over a two year period demonstrated the interval devel- opment of bihemispheric stroke-like lesions. Giant somatosensory evoked potentials and short-duration myoclonic jerks with craniocaudal spread on surface-EMG were consistent with cortical myoclonus. Optical coherence tomography showed bilateral symmetric thinning of the nerve fibre layer in the pap- illomacular bundles. Muscle biopsy was non-diagnostic, however next-generation whole mitochondrial gene sequencing identi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Khoo, A., Naidu, S., Wijayendran, S., Merve, A., Bremner, F., Sidhu, M. Tags: Live Poster, 13 May Poster Session 1 Source Type: research

031 Left internal carotid artery dissection presenting as an isolated left hypoglossal nerve palsy
A 33 year old male with no significant past medical history presented to the emergency department with an acute onset 4 day history of an odd sensation over his tongue and slurring of his speech. He had noted that his tongue deviated to the left when he stuck it out. There was no headache and no taste disturbance. Clinical examination revealed a left sided hypoglossal nerve palsy. Sensation of the tongue to pin-prick and taste was normal. There was no Horner’s syndrome. CT Angiogram of aortic arch and carotid vasculature demonstrated marked irregular calibre and increase in wall thickness of the left internal carotid...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Hanbury, G., Baheerathan, A., Auger, S., Patel, M., Gabriel, C. Tags: Live Poster, 6 May SIG4: Movement Disorders Source Type: research

115 SMART: A rare syndrome with potentially devastating consequences
We report three cases with differing neurological presentations and outcomes. A 57 year old female with previous cranial radiotherapy for a frontal astrocytoma treated 9 years earlier presented with a two week history of headache, aphasia and right sided hemiparesis. MRI Brain demon- strated new extensive left hemispheric enhancement with extensive effacement of the ipsilateral cerebral sulci. 40 days following her presentation she started to improve and is now in rehabilitation. A 33 year old female with a background of medulloblastoma treated with cranio-spinal radiotherapy 19 years earlier presented with worsening confu...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Baheerathan, A., Lynch, D., Pednekar, N., Blindheim, C., Smyth, D., Stockford, L., Rees, J. Tags: Poster Presentations Source Type: research

Radiology ruse: dural venous sinus cyst masquerading as venous sinus thrombosis presenting with headache and stroke
Conclusions Radiological differentiation between venous sinus thrombosis and dural venous sinus cyst is clinically important to avoid unnecessary anticoagulation and associated risks. Final management included propranolol for migraine prophylaxis; aspirin for acute migraine; aspirin for stroke prevention; vascular risk factor management; and cessation of triptans.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: McAulay-Powell, C., Murton, A., Tsai, W.-C., Jones, D., Froelich, J. Tags: Abstracts Source Type: research

Co-occurrence of cadasil and a parkinsonian syndrome: a report of two cases and review of the literature
Conclusions To our knowledge this represents the first autopsy-confirmed case of CADASIL with coexistent idiopathic Parkinson’s disease in a patient with a novel NOTCH3 mutation. We also report on a new genetically confirmed case of CADASIL presenting as progressive Parkinsonism.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Murray, N., Pepper, E., Blackie, J., Ronan, A., Sugo, E. Tags: Abstracts Source Type: research

Tolosa-hunt syndrome associated severe internal carotid artery stenosis resulting in cerebral infarcts
Conclusions TSH is a rare cause of ICA stenosis but has not been reported to result in ischaemic strokes. The presumed mechanism of stenosis is due to non-specific periarteritic granuloma and is generally responsive to steroid therapy. The mechanism for stroke in this patient is presumably haemodynamic and this case illustrates that THS should be recognised as a potentially reversible cause for stroke in the appropriate clinical context.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Triplett, J. D., Chemmanam, T. Tags: Abstracts Source Type: research

Miller fisher syndrome presenting with prodromal thunderclap headache
Conclusions Although not radiographically confirmed, we postulate the headache may have been due to reversible cerebral vasoconstriction syndrome (RCVS), given the characteristics of the headache and dramatic response to nimodipine. Although headache is infrequently observed in Miller Fisher syndrome, the exact aetiology is unclear and there has been no previously reported association with RCVS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Waters, M. J., Kiley, M. Tags: Abstracts Source Type: research

Nead/ functional weakness - comorbidities & diagnosis effect
This study was a historical review of 56 patient records. 45 patients had NEAD (2 with additional functional weakness) and 11 patients functional weakness only. 60.7% of patients were female, with a mean age of 44.2 years. Delay to diagnosis was 32.1 (±16.2) months. 81% of patients with functional weakness were referred from their GP, but only 51% for NEAD. No GP surgeries were identified for targeted intervention. Co-morbidities varied noticeably with diagnosis: history of epilepsy and anxiety prominent for NEAD versus other functional disorders and headache in functional weakness. Analysis of admissions data showe...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Truell, M., Hinze, S. Tags: Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Recurrent cerebral venous sinus thrombosis secondary to eltrombopag for itp
Conclusion Extensive chronic cerebral venous sinus thrombosis likely caused by abnormally structured platelets may result when Eltrombopag increases their number.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Mallick, S., Janarthen, V., Warner, G. Tags: Cranial nerves, Headache (including migraine), Pain (neurology), Stroke, Ophthalmology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

The beneficial effect of combining neurology and stroke services
Conclusion We demonstrated that patients presenting with acute neurological symptoms may benefit from early review by a neurology specialist doctor. Rapid and accurate identification and treatment of patients with stroke and non-stroke diagnoses, which are often eminently treatable, ensures that both groups receive the correct treatment and that unnecessary medication and admission is avoided.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Ingram, G., Hughes, T. Tags: Epilepsy and seizures, Headache (including migraine), Stroke, Ear, nose and throat/otolaryngology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Clinical features, course and outcomes of paediatric moyamoya
Conclusions MM is associated with multiple recurrences, progressive arteriopathy and poor outcome in half of cases, especially with AIS presentation and posterior circulation involvement. Recurrent AIS is rare after surgery but surgery was not a determinant of overall outcome; this could reflect surgical selection criteria or the patients' clinical state at referral.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Ganesan, V., Tho-Calvi, S., Thompson, D. Tags: Headache (including migraine), Pain (neurology), Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

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